Acute Encephalopathy in a Patient with Raoultella Ornithinolytica Infection: A Challenging Presentation

• Published in: Rhode Island medical journal (2013) Vol. 107; no. 6; p. 7
• Main Authors: Mader, Daniel A, Kerrigan, Danielle, Pai, Jayram
• Format: Journal Article
• Language: English
• Published: United States 03.06.2024
• Subjects: Aged; Anti-Bacterial Agents - therapeutic use; Bacteremia - diagnosis; Bacteremia - drug therapy; Bacteremia - microbiology; Brain Diseases - diagnosis; Brain Diseases - drug therapy; Brain Diseases - microbiology; Enterobacteriaceae - isolation & purification; Enterobacteriaceae Infections - diagnosis; Enterobacteriaceae Infections - drug therapy; Humans; Male; Raoultella ornithinolytica; altered mental status; UTI; encephalopathy; bacteremia
• ISSN: 2327-2228; 2327-2228

Raoultella ornithinolytica is a rare, gram-negative environmental enterobacterium. Although infections in humans caused by R. ornithinolytica are uncommon, there are increasing reports implicating it in urinary tract infections, hepatobiliary infections, and bacteremia, designating it as an emerging pathogen. Its habitat is primarily in aquatic environments and soil, with seafood frequently identified as a potential source of infection. While these infections have predominantly been described in immunocompromised patients previously, our case suggests that advanced age may be a significant risk factor. We describe a case of a 73-year-old man presenting with encephalopathy who then was found to have R. ornithinolytica bacteremia from a genitourinary source. Following antibiotic treatment, the infection resolved and the neurologic symptoms improved. To the best of our knowledge, this is the first documented case in the medical literature of R. ornithinolytica featuring a primary neurologic presentation.